DOCSLIB.ORG

"Primum Non Nocere" ["First Do No Harm"][PDF]

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Lindblad Informed Consent "Primum non nocere" ("First do no harm") Medical ethics standard attributed to Hippocrates. This Oath became obligatory for physicians prior to practicing medicine in the 4th century AD Everyone agrees there is positive value in ensuring, providing and obtaining Informed Consent when contemplating research with human subjects. For most researchers informed consent is now accepted as an ethical requirement of the research process. (5) Given the atmosphere surrounding medical research in the United States today, no one is willing to publicly renounce the concept. The fireworks begin with the discussions about how to define Informed Consent, who can give and who can get Informed Consent, what information needs to be disclosed in Informed Consent Documents, how much is to much, what constitutes coercion. The major problem is that there is no agreed upon, standardized method to determine adequate informed consent. 56 57 The differences in opinion emerge when we approach Informed consent as a process, not a document. At the center of this debate is the volunteer/subject/ participant or patient. Without this “researchee” there exists no way for the “researcher” to test his theory. It is the welfare of this central, critical element that must be ensured. The culture of individual rights has evolved over the last two centuries. The ancient Greeks, Romans and Egyptians did not practice such a concept. #13 This has brought moral and legal dilemmas that must be discussed and addressed. Respect for persons requires that they be allowed to choose what shall happen to them to the extent that they are capable of understanding. This year, more than 15 million Americans will be recruited into clinical trials. Some will be healthy, alert adults, some will be very ill fragile children-Volunteers will have many faces. Just as the trials will have differing goals, so will the individuals participating in them. The financial stakes are high. Billions of dollars will be invested in this endeavor and there will be both profits and losses. The many interested parties include government regulatory bodies, academic centers, ethicists, commercial interests and the public at large. The immense challenge is to create a system/process that will adequately respond to all. These are challenging times in clinical research. #1 With too much focus on the patient as a subject, there is the chance that there will not be enough focus on the patient as a human being. #1 Key Question-How can the Informed Consent Process be constructed to obtain the maximum value for all concerned? Medical research is the key to the development of new treatments, new drugs, new devices, new procedures and life saving changes in medical care for human beings. Clearly, that medical research can not be conducted without volunteers. It seems that this would be fairly simple given the high regard most people have for the medical community in general and physicians in particular. For thousands of years people have attempted to help and heal their fellows. Often, this took a benign course, but close inspection reveals documented examples of horrible exploitation and research that appears to have been more ‘experimentation’ then true research or care. Formal research, according to Roberta Kalechofsky, PhD. may have found its beginnings in the nineteenth century with the rise of the experimental method in science, and subsequently in medicine. She says,” The history of human experimentation in the West is usefully divided into two eras: before the Nazi era and after. Human experimentation neither arose with the Nazis, nor ended with them.” The best known recent examples are surely the awful experiments that were conducted at Buchenwald, Auschwitz and other camps during the fall of 1939 and through the spring of 1945. Despite the existence of the 1900 Berlin Code, #15 that expressly required that the human subject, in research interventions, must have given his “unambiguous consent” and that there must be proper explanations, researchers proceeded as they wished. Well over two hundred medical doctors were involved; yet later, attempts to expose and punish them ran aground when it became clear that the world governments had no defined principles that covered medical “research” and prosecutors were forced to charge the perpetrators with murder and crimes against humanity (footnote this) instead of accusing them of the horrible crimes committed during their ‘research’. As a result the famous Nuremberg Code, the first international document to provide research ethics guidelines was developed. An interesting side note is that many American and European medical personnel felt that the code was unnecessary and did not apply to them. This had far reaching consequences in the years to come. The Nuremberg Code made voluntary consent and freedom from coercion necessary conditions of clinical research studies. In addition, 1 Lindblad Informed Consent participants must be able to comprehend the risks and benefits of their participation and feel free to leave the project or study if they choose. What Happened: History Anthony S. Kessel says that the word ethics refers to the general beliefs, attitudes or standards that guide customary or community behavior. # 10 Ethics and healthcare have been the subjects of debate and discussion for centuries. However, biomedical ethics - synonymous with medical ethics or healthcare ethics - developed as a discipline of its own in the 1960s, initially in the United State. The emergence of the scientific era, with it’s bursts of curiosity, eruption of information and the explosion of knowledge brought about radical changes in medicine. But the need to know and the urge to explore and discover reasons vastly predate the 1900’s. Cleopatra is said to have wondered about the time it took for a male fetus to develop. She supervised experiments among her maids to test the theory that male fetus was fully developed in 40 days and a female in 80. Her servants were impregnated and killed at differing times of gestation to find the answer. # 7 Wera Sharav records that the Book of Daniel tells of meat and vegetable experiments that were done using Jewish prisoners. Dr. Edward Jenner infected a local child with cowpox and three months later with smallpox in 1776. This lead to widespread policies of vaccination and the eventual eradication of smallpox. However, rarely if ever, is this early researcher criticized for his ‘use’ of the neighborhood child, an expendable person. In1895, the famous chemist E.E. Slosson wrote (and was published in the New York Independent), “A human life is nothing compared with a new fact in science…” #14 In 1913 the Pennsylvania House of Representative recorded 146 children that had been inoculated with the syphilis virus “through the courtesy of various hospitals” and that others had had tuberculin put in their eyes. Several of these children became blind. The experimenters were not punished! #14 In 1931, Dr. Cornelius Rhoads, under the auspices of the Rockefeller Institute for Medical Investigations, infected human subjects with cancer cells. He went on to establish U.S. Army Biological Warfare facilities and was named to the U.S. Atomic Energy Commission. While there, he began a series of radiation exposure experiments on American soldiers and civilian hospital patients. Of great concern, is that frequently, these individuals experienced slight, if any, degree of censure at the time of their research and rarely suffered negative consequences. They often advanced in their careers, earning professional respect and financial stability. This heritage has lead many to continue to advance the defense first suggested by Celus, a physician in the 1st century AD. He is quoted as saying, “It is not cruel to inflict on a few criminals sufferings which may benefit multitudes of innocent people through all centuries.” #20 This certainly supports the use of the ongoing recruitment and use of expendable, vulnerable and disadvantaged individuals in clinical research. Even after the Nuremberg Code was written and accepted, many in the United States continued to experiment under their own individual policies. Perhaps this was encouraged by the fact that although the Japanese had conducted experiments very similar to the Nazi’s (many on American prisoners of war) during the war, the United States government choose to not pursue punishment in exchange according to the Advisory committee on Human radiation Experiments for the information gleaned during those experiments. # 19 # 14, Almost all researchers have now heard of the infamous Tuskegee situation, conducted under the auspices of the United States federal government. Those individuals and their families received a belated apology from President William Clinton in 19______. Even a cursorily look at more recent events shows an ongoing difference in belief systems and personal and institutional practice. More recent examples collected by the Association for Human Research Protection include: 1940’s and 1950’s - The Atomic Energy Commission continued to follow studies that involved giving civilian’s cereal that had radioactive tracers. 1947 - The CIA began its study of LSD as a potential weapon for use by American intelligence. Human subjects (both civilian and military) were used with and without their knowledge. 2 Lindblad Informed Consent 1950 – The Department of Defense began plans to detonate nuclear weapons in desert areas and monitor downwind residents for medical problems and mortality rates. 1950 - In an experiment to determine how susceptible an American city would be to biological attack, the U.S. Navy sprayed a cloud of bacteria from ships over San Francisco. Monitoring devices were situated throughout the city in order to test the extent of infection. Many residents become ill with pneumonia-like symptoms. 1956 – The U.S. military releases mosquitoes infected with Yellow Fever over Savannah, Georgia and Avon Park, Florida. Following each test, Army agents posing as public health officials tested victims for effects.
Load more

Recommended publications
  • Confidentiality in Arbitration: Beyond the Myth Richard C
    University of Missouri School of Law Scholarship Repository Faculty Publications 2006 Confidentiality in Arbitration: Beyond the Myth Richard C. Reuben University of Missouri School of Law, [email protected] Follow this and additional works at: http://scholarship.law.missouri.edu/facpubs Part of the Dispute Resolution and Arbitration Commons, and the Evidence Commons Recommended Citation Richard C. Reuben, Confidentiality in Arbitration: Beyond the Myth, 54 U. Kan. L. Rev. 1255 (2006) This Article is brought to you for free and open access by University of Missouri School of Law Scholarship Repository. It has been accepted for inclusion in Faculty Publications by an authorized administrator of University of Missouri School of Law Scholarship Repository. Confidentiality in Arbitration: Beyond the Myth Richard C. Reuben* I. INTRODUCTION Confidentiality has long been part of the mythology of alternative dispute resolution (ADR). That is to say, one of the apparent virtues of ADR is that its processes have been viewed as confidential. This aspect of the mythology has come under more scrutiny in recent years, particularly in the mediation context.2 This is not surprising considering the popularity of mediation 3 and the centrality of confidentiality to the mediation process. 4 Confidentiality was the primary thrust of the Uniform Mediation Act (UMA), 5 and in their * Richard C. Reuben is an associate professor of law at the University of Missouri-Columbia School of Law. I would like to thank Chris Drahozal, Steve Ware, and the members of the Kansas Law Review for inviting me to participate in this symposium, and all of the symposium participants for their helpful comments.
    [Show full text]
  • Did I Do That?
    Did I Do That? ISSUES IN COMMUNICATION, DOCUMENTATION, AND RISK IN HEALTHCARE DECISIONS. Andy McLean, MD, MPH OBJECTIVES Describe risk and protective factors in doctor-patient communication Understand the importance of appropriate health record documentation in the era of patient-centered care Articulate an awareness of how to “expand the field” when involved in difficult healthcare decisions The Art of Medicine Medical Ethics • 4 Principles: • Autonomy* • Beneficence- (Dr. should act in Pt. best interest) • Non-Maleficence- “primum non nocere” prē-mu m-̇ ˌnōn-no -̇ ˈkā-rā (first, do no harm) Justice-fairness (as in, allocation of resources) Harm combinations Resulting from the underlying Resulting from the care/services medical condition provided to the patient Inherent risk of treatment Systems failure Provider performance Canadian Medical Protective Association What happened? Duty-A physician has a duty to provide competent care to a patient Breach-Did the physician’s conduct, whether by act or omission, fall below the applicable standards of care? Causation- “But for…” Proximate cause (foreseeability) Damages Breach- Omissions of Fact and Judgment Fact- Did you review all the facts you knew or should have known… Judgment- Once reviewed, did you make a reasonable clinical decision, and document such? It is recognized that physician’s aren’t perfect and that even with reasonable care, negative outcomes occur. You are much more likely to be “forgiven” if you documented how you weighed your decision (based on the facts…) “Foreseeability”
    [Show full text]
  • Defining Remission in Rheumatoid Arthritis: What Is It? Does It Matter?
    Editorial Defining Remission in Rheumatoid Arthritis: What Is It? Does It Matter? When the American College of Rheumatology (ACR) criteria for remission include 6 signs and symptoms: fatigue, preliminary criteria for remission1 were developed in 1981, joint pain, morning stiffness, joint tenderness, joint patients with established rheumatoid arthritis (RA) rarely swelling, and erythrocyte sedimentation rate (ESR); phys- experienced remission, although a number of patients with ical function and structural damage to joints are ignored. recent onset of polyarthritis had periods when their RA The DAS (Disease Activity Score) index uses a mathemat- temporarily regressed or remitted and a few had prolonged ical formula to arrive at a single composite quantitative remission or even permanent recovery from the disease. score representing tender joints (Ritchie index), swollen This was more frequent in children with oligoarthritis, and joints (44-joint count), Westergren ESR and patient’s global was generally considered to be a gift from God. The guiding assessment (0–100 visual analog scale) of disease activity6. principle for treatment of RA was “primum non nocere,” It is a useful continuous quantitative summary measure of exemplified by the therapeutic pyramid. Because RA was signs and symptoms of RA inflammation, similar to the expected to persist for the lifetime of the patient, available signs and symptoms included in the dichotomous ACR drugs were used cautiously so one would not run out of ther- remission criteria, but also ignores physical function and apeutic options too rapidly. For most patients therapy had structural damage. The DAS-28 uses the abbreviated 28- little effect on continued disease progression.
    [Show full text]
  • Physician Responsibility on the Frontiers of Tort Law
    DePaul Law Review Volume 57 Issue 2 Winter 2008: Symposium - Challenges to the Attorney-Client Relationship: Threats to Article 6 Sound Advice? Dissembling and Disclosing: Physician Responsibility on the Frontiers of Tort Law Robert L. Rabin Follow this and additional works at: https://via.library.depaul.edu/law-review Recommended Citation Robert L. Rabin, Dissembling and Disclosing: Physician Responsibility on the Frontiers of Tort Law, 57 DePaul L. Rev. 281 (2008) Available at: https://via.library.depaul.edu/law-review/vol57/iss2/6 This Article is brought to you for free and open access by the College of Law at Via Sapientiae. It has been accepted for inclusion in DePaul Law Review by an authorized editor of Via Sapientiae. For more information, please contact [email protected]. DISSEMBLING AND DISCLOSING: PHYSICIAN RESPONSIBILITY ON THE FRONTIERS OF TORT LAW Robert L. Rabin* INTRODUCTION This Commentary addresses an issue that emerges as a common theme in the three papers in this Symposium Issue dealing with legal considerations in advising physicians: are there circumstances in which telling "less than the whole truth" is warranted?1 In a bygone era, physicians would have had no difficulty providing an affirmative answer to this question. Well into the twentieth century, it was com- mon practice to withhold from patients the dire news that they suf- fered from a terminal illness. In a different context, the consensus view until the latter part of the century was the so-called "physician's standard" in informed consent cases; that is, the practice of informing a patient of only those risks associated with an anticipated medical procedure that the physician deemed advisable to disclose to the pa- tient.
    [Show full text]
  • Code Gray.Pub
    Written by Christine Mitchell, RN, FAAN and Ben Achtenberg with a historical commentary by Susan Reverby, PhD and assistance from Joan Sawyer and Karen Wolf, RN, MS Contents INTRODUCTION ....................................................................................... 3 Background ............................................................................................3 Synopsis of the Film ..............................................................................3 Suggested Uses .......................................................................................4 Scheduling ..............................................................................................4 FILM AS A TOOL FOR DISCUSSION .......................................................4 WHAT IS NURSING ETHICS? ...................................................................5 GLOSSARY ...................................................................................................5 SOME GENERAL DISCUSSION QUESTIONS ........................................6 CASE 1: BENEFICENCE ............................................................................7 Description of the Case .........................................................................7 The Principle: Beneficence ...................................................................7 Questions for Discussion ......................................................................8 CASE 2: AUTONOMY ................................................................................9 Description
    [Show full text]
  • First, Do No Harm”: Old and New Paradigms in Prehospital Resuscitation in the Aquatic Domain
    International Journal of Aquatic Research and Education Volume 10 Number 2 Article 5 10-16-2017 “First, Do No Harm”: Old and New Paradigms in Prehospital Resuscitation in the Aquatic Domain John H. Pearn Lady Cilento Children's Hospital, Brisbane, Queensland, Australia, [email protected] Richard Charles Franklin James Cook University, [email protected] Follow this and additional works at: https://scholarworks.bgsu.edu/ijare Part of the Applied Ethics Commons, Bioethics and Medical Ethics Commons, Health and Physical Education Commons, Legal Theory Commons, Leisure Studies Commons, Medicine and Health Commons, Social and Philosophical Foundations of Education Commons, and the Social Control, Law, Crime, and Deviance Commons Recommended Citation Pearn, John H. and Franklin, Richard Charles (2017) "“First, Do No Harm”: Old and New Paradigms in Prehospital Resuscitation in the Aquatic Domain," International Journal of Aquatic Research and Education: Vol. 10 : No. 2 , Article 5. DOI: https://doi.org/10.25035/ijare.10.02.05 Available at: https://scholarworks.bgsu.edu/ijare/vol10/iss2/5 This Education Article is brought to you for free and open access by the Journals at ScholarWorks@BGSU. It has been accepted for inclusion in International Journal of Aquatic Research and Education by an authorized editor of ScholarWorks@BGSU. Pearn and Franklin: First, Do No Harm Abstract The balance between benefit and risk is central to the work of all those involved in aquatic services. The Hippocratic exhortation of Primum non nocere, “First, do no harm,” has a history of over 2000 years. Superficially, all would support this dictum, but harm can result from inaction.
    [Show full text]
  • Protecting Human Research Participants NIH Office of Extramural Research Introduction
    Protecting Human Research Participants NIH Office of Extramural Research Introduction Research with human subjects can occasionally result in a dilemma for investigators. When the goals of the research are designed to make major contributions to a field, such as improving the understanding of a disease process or determining the efficacy of an intervention, investigators may perceive the outcomes of their studies to be more important than providing protections for individual participants in the research. Although it is understandable to focus on goals, our society values the rights and welfare of individuals. It is not considered ethical behavior to use individuals solely as means to an end. The importance of demonstrating respect for research participants is reflected in the principles used to define ethical research and the regulations, policies, and guidance that describe the implementation of those principles. Who? This course is intended for use by individuals involved in the design and/or conduct of National Institutes of Health (NIH) funded human subjects research. What? This course is designed to prepare investigators involved in the design and/or conduct of research involving human subjects to understand their obligations to protect the rights and welfare of subjects in research. The course material presents basic concepts, principles, and issues related to the protection of research participants. Why? As a part of NIH's commitment to the protection of human subjects and its response to Federal mandates for increased emphasis on protection for human subjects in research, the NIH Office of Extramural Research released a policy on Required Education in the Protection of Human Research Participants in June 2000.
    [Show full text]
  • The Hippocratic Oath and Principles of Medical Ethics
    MEDICINE AND PUBLIC POLICY The Hippocratic Oath and Principles of Medical Ethics Gilbert Berdine MD The Hippocratic Oath is associated with the morally right. This tradition remains in the modern practice of medicine, but over time fewer medical era. “As God is my witness I hereby pledge to …” can graduates have taken any form of the Hippocratic be found in modern rituals to stress the seriousness Oath. As of 2006, the State University of New York of purpose. Courts in the U.S. require prospective Upstate Medical School in Syracuse was the only witnesses to pledge their truthfulness: “Do you sol- U.S. medical school that administered the classic emnly swear or affirm that you will tell the truth, the version of the Hippocratic Oath to its graduates. The whole truth, and nothing but the truth, so help you Hippocratic Oath has been revised to make it more God?” This pledge becomes a source of contention in acceptable to modern schools, but the medical pro- a multi-cultural society as some members believe in fession no longer has a common set of promises that other deities. guide it. This article will look at the classic version of the Hippocratic Oath to see why it has been aban- Anyone who takes his or her religion seriously doned. Modern medical students wish to graduate would not pledge to a pagan god as this would be a into an ancient order of physicians, so they long for form of idolatry. This pledge is probably the main rea- a solemn ceremony, but it is difficult to craft a solemn son that the Oath has been abandoned in the modern ceremony that remains agreeable to a diverse group era, but what can take its place as a symbol of seri- of students.
    [Show full text]
  • Primum Non Nocere
    65 à la mort. Cependant, la formation en Primum Non oncologie met l’accent sur le trait- ement du cancer et fait très peu de Nocere: place à la relation d’aide en prépa- Reflections of a ration à la mort. Des médecins tels Bahá’í Oncologist que l’écrivain Atul Gawande veulent ramener le sujet de la mort dans la about Treating the conversation entre le médecin et Dying Patient le patient. De plus, bon nombre de religions, dont la foi bahá’íe, peuvent aider à examiner comment les mé- AARON ALIZADEH decins perçoivent et abordent le sujet de la mort. Dans le présent article, je Dedicated to Carley Elle Allison traite de mon expérience personnelle en tant qu’oncologue et en tant que July 18 1995 - March 31 2015 bahá’í en ce qui concerne le sujet de la mort. Abstract Medical oncology is a subspecialty of Resumen internal medicine that focuses on the Oncología médica es una subespecialidad treatment of cancer. Cancer is the sec- de la medicina interna que se encarga en el ond leading cause of mortality in the U.S. tratamiento del cáncer. El cáncer es la se- Therefore death is a frequent subject for gunda causa de mortalidad en los Estados oncologists. However, oncology train- Unidos. Por lo tanto la muerte es un tema ing emphasizes cancer therapy with little frecuente para los oncólogos. Sin embargo, guidance on counseling in preparation for la formación oncológica enfatiza el trata- death. Physicians such as the writer Atul miento del cáncer con poca orientación en Gawande are working to bring back the la preparación para la muerte.
    [Show full text]
  • Another Misunderstood Relation: Confidentiality and the Duty to Report Peter K
    Marquette University Law School Marquette Law Scholarly Commons Faculty Publications Faculty Scholarship 1-1-2001 Another Misunderstood Relation: Confidentiality and the Duty to Report Peter K. Rofes Marquette University Law School, [email protected] Follow this and additional works at: http://scholarship.law.marquette.edu/facpub Part of the Law Commons Publication Information Peter K. Rofes, Another Misunderstood Relation: Confidentiality and the Duty to Report, 14 Geo. J. Legal Ethics 621 (2001). Posted with permission of the publisher, The Georgetown Journal of Legal Ethics © 2001. Repository Citation Rofes, Peter K., "Another Misunderstood Relation: Confidentiality and the Duty to Report" (2001). Faculty Publications. Paper 292. http://scholarship.law.marquette.edu/facpub/292 This Article is brought to you for free and open access by the Faculty Scholarship at Marquette Law Scholarly Commons. It has been accepted for inclusion in Faculty Publications by an authorized administrator of Marquette Law Scholarly Commons. For more information, please contact [email protected]. Another Misunderstood Relation: Confidentiality and the Duty to Report PETER K. ROFES* INTRODUCTION: THE REPORTING DUTY AND ITS PARADOXES Over the past two decades, the duty imposed on most American lawyers to report the misconduct of their peers has garnered substantial attention across the professional landscape. From courts and state bar ethics committees to scholars, practitioners, and law students, the duty - once deemed a quaint aspirational guidepost of dubious practical importance - has increasingly engaged the resources of all segments of the profession. In particular, it would be no exaggeration to observe that the treatment of the reporting duty by courts and ethics committees has triggered a cottage industry of commentary, both in scholarly and professional journals and on the continuing legal education circuit.' * Professor of Law and Director of Part-time Legal Education, Marquette University Law School.
    [Show full text]
  • Medical Ethics
    Medical Ethics Janyne Althaus, M.D., M.A. Dept. Gyn-Ob Div. Maternal-Fetal Medicine Johns Hopkins University School of Medicine Hippocratic Oath 12th-century Byzantine manuscript of the Oath Late 5th Century B.C. Basic Principles of Medical Ethics 1. Non-maleficence 2. Beneficence 3. Autonomy 4. Justice Primum non nocere Bloodletting High Oxygen for respiratory distress in premature infants Healing should be the sole purpose of medicine, and that endeavors like cosmetic surgery, contraception & euthanasia fall beyond its purview. Jehovah’s Witnesses Primary Elective Cesareans Cosmetic Gynecology Counseling parents of 24 week fetus Neonatal Intensive Care Units Transplants Forced sterilization of mentally retarded in Virginia United States of America v. Karl Brandt, et al. A sentence of death by hanging is pronounced by a US War Crimes Tribunal upon Adolf Hitler's personal physician, 43-year old Karl Brandt. Brandt was also Reich Commissar for Health and Sanitation. Of the 23 defendants, 7 were acquitted and 7 received death sentences; 9 received prison sentences ranging from 10 years to life imprisonment. Tuskegee Syphilis Experiment Peter Buxtun, PHS veneral disease investigator, the “whistleblower". •Conducted by the U.S. Public Health Service from 1932-1972 •600 Rural African-American men thought they were receiving free health care from the government. •By the end of the study in 1972, only 74 of the test subjects were alive. Of the original 399 men with syphilis, 28 had died of syphilis, 100 were dead of related complications, 40 of their wives had been infected and 19 of their children were born with congenital syphilis.
    [Show full text]
  • Daniel Patrick Moynihan and the Defense of Academic Medicine
    10 The Pharos/Spring 2017 Primum non nocere: Daniel Patrick Moynihan and the defense of academic medicine Joseph J. Fins, MD, MACP; Joan M. Leiman, PhD; and Herbert Pardes, MD Dr. Fins (AΩA, Weill Cornell Medical College, 2011, ...[M]edical education was one of the issues that Pat was Faculty) is the E. William Davis, Jr., MD, Professor of most interested in. He was deeply concerned with poverty Medical Ethics; Chief of the Division of Medical Ethics; in America & always worked on issues connected to that. Professor of Medicine; Professor of Medicine in Psychiatry; He also felt that the most important duty of a Senator was Professor of Medical Ethics in Neurology; and Professor to choose the best men/women as Federal judges. These of Health Care Policy and Research at Weill Medical were the 3 issues he cared most about…1 College of Cornell University. He is also the Director of Medical Ethics at New York-Presbyterian Weill Cornell Although Moynihan was not alone in his advocacy for Medical Center; Solomon Center Distinguished Scholar in academic medicine, it became one of his key legislative pri- Medicine, Bioethics and the Law at Yale Law School; and orities. While other leaders, like Senator Ted Kennedy (D- a member of The Pharos Editorial Board. MA) focused more on universal access to care, Moynihan’s Dr. Leiman is a Fellow at the New York-Presbyterian focus increasingly became the fate of academic medicine. Health Policy Center. Adam Clymer of The New York Times observed that Dr. Pardes (AΩA, State University of New York, Downstate Moynihan, “… carped on television about their [Clintons’] Medical Center, 1960) is Executive Vice Chairman, and health plan, quickly fixing on the role of teaching hospitals former President and CEO of New York-Presbyterian as the biggest issue in health care.” 2 Hospital.
    [Show full text]